Telerehabilitation in Patients With Peripheral Arterial Disease

This prospective, single-arm study evaluated the feasibility and implementation of a 6-month home-based telerehabilitation program in patients with peripheral arterial disease (PAD) of the lower limbs. The intervention consisted of an individually prescribed walking-based physical activity program performed at home, supported by wearable activity monitoring and weekly telephone counselling. Participants used a Xiaomi Smart Band 8 to monitor daily step counts and were encouraged to progressively increase their physical activity according to individualized weekly targets. During the weekly telephone contacts, the investigator reviewed the participant's activity during the preceding 7 days, assessed adherence and provided individualized encouragement and guidance regarding continuation and progression of the walking program.

Clinical, functional, laboratory, and health-related quality-of-life assessments were performed at baseline, 3 months, and 6 months. Functional evaluation included the 6-minute walk test, ankle-brachial index, and cardiopulmonary exercise testing. Laboratory assessments included selected cardiometabolic and inflammatory parameters. Disease-specific health-related quality of life was assessed using validated PAD-specific questionnaires.

The study was designed to evaluate the feasibility and adherence to a digitally supported home-based rehabilitation model and to explore longitudinal changes in physical activity, functional capacity, quality of life, and selected clinical and laboratory parameters during the 6-month intervention period. As the study used a single-arm design without a control group, longitudinal changes were considered exploratory and cannot be interpreted as causal effects of the intervention.

Inclusion criteria

• age ≥18 years;
• diagnosis of PAD, defined by an ankle-brachial index (ABI) ≤0.90, arterial stenosis >70% documented by angiography, or previous lower-extremity revascularization;
• ability to safely perform walking exercise at home;
• ability to use the activity-monitoring device and read the number of daily steps displayed on the device;
• access to and ability to use a mobile phone for telephone counseling;
• ability to complete the activity journal;
• provision of written informed consent.

Exclusion criteria

• chronic limb-threatening ischemia (CLTI);
• locomotor disability preventing participation in the walking exercise program;
• significant visual or hearing impairment interfering with participation in the in-tervention;
• moderate-to-severe cognitive impairment, defined as a Mini-Mental State Examination (MMSE) score <17 [17];
• requirement for long-term oxygen therapy;
• incomplete medical records;
• inability to provide reliable information required for study assessments.